Distribution and drug resistance of pathogenic bacteria of biliary tract infection in patients subjected to hepatobiliary surgery / 中国基层医药

Objective:To study the distribution and drug resistance of pathogenic bacteria of biliary tract infection in patients with hepatobiliary surgery.Methods:A total of 103 patients with biliary tract infection who received treatment in the Department of Hepatobiliary Surgery, Lanxi People's Hospital from May 2020 to October 2022 were included in this study. Their bile was cultured to analyze the distribution and drug resistance of pathogenic bacteria. The data were processed using the WHONET5.5 software system.Results:Fifty-eight pathogenic bacteria-positive samples were cultured from the bile of 103 patients with biliary tract infection, with a pathogenic bacteria-positive rate of 56.31%. Among 58 strains of pathogenic bacteria, 38 strains (65.52%) were gram-negative bacteria, mainly Escherichia coli and Klebsiella pneumonia, and 5 strains (8.62%) were fungal strains. Escherichia coli and Klebsiella pneumoniae were highly resistant to sulfamethoxazole-trimethoprim, ciprofloxacin, and other antibacterial drugs, and were completely sensitive to imipenem and meropenem. Enterococcus faecalis was mainly resistant to ampicillin and penicillin G,and it was completely sensitive to vancomycin and teicoplanin. Staphylococcus aureus was resistant to vancomycin, ciprofloxacin, cefotaxime, and other drugs. A total of 13 strains of ultrabroad-spectrum beta-lactamase bacteria were isolated from 25 strains of Escherichia coli and 7 strains of Klebsiella pneumonia, with the positive detection rate of 40.63%. Conclusion:The main pathogenic bacteria of biliary tract infection are Gram-negative bacteria, which are widely distributed and have serious drug resistance. In clinical practice, antimicrobial drugs should be reasonably selected according to the results of bile drug sensitivity tests.

Research progress on grief of bereaved children / 中国学校卫生

Abstract@#Bereavement during childhood is the stressful life event that children may experience in their growing up, while most bereaved children will eventually adapt, some may be severely affected, with potential risks to their healthy physical and mental development,it also has potential risks to the healthy development of children s body and mind.This article reviews the characteristics and associated factors with grief in bereavement children, and summarizes the main intervention approaches for bereavement children s grief, aiming to provide a reference for further research on bereavement children s grief in different age groups and to explore effective intervention models.

Long-term efficacy of stapled transanal rectal resection for obstructed defecation syndrome / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the long-term efficacy of stapled transanal rectal resection (STARR) in treating obstructed defecation syndrome(ODS).</p><p><b>METHODS</b>Clinical data of 95 female patients with ODS undergoing STARR at Department of Colorectal Surgery, Rocket Army General Hospital from February 2010 to August 2012 were analyzed retrospectively. The Cleveland constipation scoring system (CSS), Longo ODS scoring system and severe symptoms score(SSS) were used to evaluate the degree and intensity of clinical symptoms. Patient satisfaction was assessed by visual analogue scale (VAS). Clinical symptoms at postoperative 12-month were defined as short-term efficacy, and at the end of follow up (≥48 months) were defined as long-term efficacy.</p><p><b>RESULTS</b>The mean age was 54.5 (29 to 79) years and the median follow-up was 65 (48 to 78) months. Eighty (84.2%) and 44 (46.3%) patients completed the short-term and long-term efficacy evaluation respectively. At the end of follow up, compared with the baseline levels before operation, the CSS score (14.69 vs. 6.02), ODS score (16.51 vs. 5.73) and SSS score (14.64 vs. 5.14) were significantly decreased (all P<0.01), but the VAS score (3.96 vs. 7.20, P<0.01) was significantly increased. A total of 10 patients (22.7%) developed symptomatic recurrence. The self-reported definitive satisfaction was excellent in 10 (22.7%) patients, fairly good in 17(38.6%), good in 9(20.5%), and poor in 8(18.2%). The total effective rate was 81.8%(36/44).</p><p><b>CONCLUSION</b>Long-term efficacy of STARR in the treatment of ODS is good, but the rate of symptomatic recurrence is relatively high.</p>

Preliminary discussion on emergency early diagnosis of atypical acute aortic dissection / 中国中西医结合急救杂志

Acute aortic dissection (AAD) is a cardiovascular critical serious disease, and the clinical manifestations of AAD are diverse and complicated. The emergent early diagnosis is often challenging, and misdiagnosis or delay in diagnosis may result in serious consequences. The process of diagnosis and treatment of a patient with Stanford A type AAD firstly manifesting atypical signs and symptoms of osphyalgia and paraplegia was retrospectively analyzed. The related literatures were reviewed to discuss the early diagnostic strategies used in this atypical emergent patient with AAD.

Z-scores analysis of kidney in normal fetuses with two-dimension ultrasound / 中华医学超声杂志（电子版）

Objectives To develop Z-scores reference ranges for kidney in normal fetuses from the measurements of gestational age (GA),biparietal diameter (BPD) or femur length (FL) using two-dimension ultrasound.Methods A retrospective cross-sectional study of 403 singleton normal fetuses was performed.The gestation age range was from 18 to 40 weeks.Fetal biologic parameters included GA and BPD and FL based on menstrual age.Left kidney length and left kidney width of normal fetus were measured.Normal Z-score ranges were developed for leftkidney length or left kidney width using GA,BPD and FL as independent variables.Results Linear regression model was the best description of the data in each case and correlation between left kidney length or left kidney width and independent variables were excellent (r=0.8761,0.8818,0.8797,0.8604,0.8723,0.8643).All P values were less than 0.01.The equations were as follows,Y=0.094 22 + 0.1088X,Y=0.132 57 + 0.4349X,Y=0.6664 + 0.491 05X,Y=0.060 58X-0.051 98,Y=0.262 19X-0.197 55,Y=0.294 02X + 0.136 19.Heteroscedasticity of standard deviation (s) with increasing independent variables also could be modeled with a simple linear (r=0.925,0.934,0.915,0.908,0.914,0.922),All P values were less than 0.01.The equations were as follows,Y=0.025 + 0.005 58X,Y=0.097 09 + 0.010 45X,Y=0.046 17 + 0.025 65X,Y=0.001 13 + 0.002 24X,Y=0.003 67 + 0.011 55X,Y=0.005 07 + 0.015 89X.Then we got Z-scores based on the equation,Z-score=(actual measurement data of left kidney length or left kidney width-predictive data of left kidney length or left kidney width) predictive s.Conclusions Normal reference ranges and Z-scores for fetal left kidney length and left kidney width had been provided.These normative data may be useful tools for assessment of fetal kidney length and kidney width,especially had potential applications in malformations of fetal kidney.

Effect of Arm Spasticity Inhibitor on Upper Extremities Spasticity with Shoulder Subluxation after Stroke / 中国康复理论与实践

@#Objective To observe the effect of Arm Spasticity Inhibitor worn in rehabilitation training on patients with upper extremities spasticity and shoulder subluxation after stroke. Methods 80 stroke patients with flexor spasm in upper extremities complicated with subluxation of shoulder were divided into treatment group and control group equally. Both groups accepted routine medicine and rehabilitation, and the treatment group wore the Arm Spasticity Inhibitor developed ourselves during the rehabilitation training. Their acromio-humeral interval (AHI) was measured with the X- ray; and they were assessed with modified Ashworth Scale (MAS), range of motion of shoulder (ROM) and elbow before and 2 months after treatment. Results It improved more in the AHI, score of MAS and ROM in the treatment group than in the control group after treatment (P<0.001). Conclusion Wearing Arm Spasticity Inhibitor during rehabilitation training may release the spasticity of upper extremities and shoulder subluxation, and improve shoulder function in patients after stroke.

Effect of Arm Spasticity Inhibitor on Upper Extremities Spasticity with Shoulder Subluxation after Stroke / 中国康复理论与实践

Objective To observe the effect of Arm Spasticity Inhibitor worn in rehabilitation training on patients with upper extremities spasticity and shoulder subluxation after stroke. Methods 80 stroke patients with flexor spasm in upper extremities complicated with sublux-ation of shoulder were divided into treatment group and control group equally. Both groups accepted routine medicine and rehabilitation, and the treatment group wore the Arm Spasticity Inhibitor developed ourselves during the rehabilitation training. Their acromio-humeral in-terval (AHI) was measured with the X-ray; and they were assessed with modified Ashworth Scale (MAS), range of motion of shoulder (ROM) and elbow before and 2 months after treatment. Results It improved more in the AHI, score of MAS and ROM in the treatment group than in the control group after treatment (P<0.001). Conclusion Wearing Arm Spasticity Inhibitor during rehabilitation training may release the spasticity of upper extremities and shoulder subluxation, and improve shoulder function in patients after stroke.

Effect of Acupuncture, Neuromuscular Electrical Stimulation and Swallowing Training on Acute Stroke Patients with Dysphagia and Incidence of Post-stroke Pneumonia / 中国康复理论与实践

@#Objective To observe the effect of acupuncture, neuromuscular electrical stimulation and swallowing training on acute stroke patients with dysphagia and the incidence of post-stroke pneumonia (PSP). Methods Acute stroke patients with dysphagia were divided into 3 groups. Routine group (n=188) received routine swallowing training. Stimulation group (n=196) received routine swallowing training and neuromuscular electrical stimulation. Acupuncture group (n=112) received routine swallowing training, neuromuscular electrical stimulation, and acupuncture. The incidence of improvment of dysphagia and PSP, and the improvement of National Institutes of Health Stroke Scale (NIHSS) within 3 weeks were compared. They were followed up for 3 months for the incidence of PSP. Results The incidence of improvment of dysphagia was the most in the acupuncture group (P<0.05), while the incidence of PSP was the least (P<0.05). The improvement of NIHSS was the most in the acupuncture group (P<0.05). The incidence of PSP was not significantly different (P>0.05) within 3 months followed up. Conclusion The acupuncture, neuromuscular electrical stimulation and swallowing training combination can improve the swallowing function and decrease the incidence of PSP in stroke patients with dysphagia.